The Stretta procedure is a modern solution for effectively treating gastroesophageal reflux disease

If you suffer from persistent heartburn, nighttime acidity, or acid reflux into the esophagus, the Stretta procedure may be the ideal solution for you. The Stretta technique is a non-surgical procedure that focuses on strengthening the lower esophageal sphincter to prevent acid reflux, reducing symptoms quickly and restoring comfort after meals and during sleep.In this article, we will explore what the Stretta procedure is, its steps, benefits, expected results, and post-procedure diet, in a clear and easy-to-understand way, helping you grasp all the details before making a medical decision.

What is the Stretta Procedure?

The Stretta procedure is a non-surgical technique designed to strengthen the lower esophageal sphincter (LES), the muscle between the esophagus and stomach, to prevent acid reflux.

The procedure uses an endoscope and precise instruments to deliver radiofrequency energy to the sphincter muscle.
Main idea: Improve sphincter function without surgery or incisions.

⏱ How Long Does the Procedure Take?

The procedure is very short, usually less than an hour.
Patients can typically return home one hour after the procedure.

Type of Anesthesia

Usually, local anesthesia with mild sedation is used.
The patient remains awake but completely comfortable, without the need for general anesthesia.

✨ When Does Improvement Begin?

Most patients notice relief from heartburn and reflux within about a month.
Some may stop taking reflux medications within two months.
Improvement continues gradually for up to six months after the procedure.

⚠️ When is Stretta Recommended?

Stretta is not always the first option and is usually recommended when:

Medications such as antacids or proton pump inhibitors (PPIs) do not provide sufficient relief.
The patient needs a non-surgical solution to reduce acid reflux.

The final decision is made by a gastroenterologist after a complete evaluation.

Is Stretta Surgery?

No, Stretta is not traditional surgery.
It is a non-surgical, endoscopic procedure for treating acid reflux.
There are no surgical cuts or stitches, reducing risk and allowing a quick return to normal life.

What is Acid Reflux and Why Might Surgery Be Needed?

Acid reflux occurs when stomach acid flows back into the esophagus, causing:

Chest heartburn
Bitter taste in the mouth
Difficulty swallowing
Sometimes hoarseness or chronic cough

If medication fails and symptoms worsen, surgery may be needed to protect the esophagus from long-term complications such as:

Chronic inflammation
Cellular changes that rarely can lead to cancer

✅ Is Stretta Safe?

Stretta is one of the safest and most effective solutions for treating acid reflux:

Evaluated in over 40 clinical studies
Performed on more than 25,000 patients
Results show significant, lasting improvement for 4–10 years

✨ Stretta Results

Most patients notice symptom relief within 2–6 months.
The lower esophageal sphincter becomes stronger, reducing acid reflux gradually.
Over 80% of patients can discontinue reflux medications such as PPIs.

⚠️ Is Stretta Suitable for Hiatal Hernia Patients?

For large hiatal hernias, other procedures like fundoplication may be better.
The doctor decides the appropriate procedure based on hernia size and patient condition.

Types of Stretta Procedures

Conventional Stretta
- Standard and most common method.
- A catheter with small electrodes is inserted into the lower esophagus.
- Heat strengthens the sphincter to improve function.
- Suitable for mild to moderate reflux.
Advanced Endoscopic Stretta
- Modern version with more precise devices for heat control.
- Reduces inflammation or irritation.
- Better results for patients with small hernia or persistent reflux.
Stretta with Manometry Guidance
- Uses pressure-measuring devices inside the esophagus.
- Ensures proper heating tailored to each patient.
- Provides higher accuracy and predictable results.
Partial Stretta
- Heat applied to specific areas of the sphincter, not the entire muscle.
- Suitable for mild reflux or partially weak sphincters.

⚡ Alternatives to Stretta

Nissen Fundoplication: Wraps upper stomach around LES, performed laparoscopically.
Toby Fundoplication: Partial stomach wrap around LES, laparoscopic.
LINX: Magnetic ring implanted around LES to strengthen it.
Stretta: Non-surgical, strengthens LES without incision.

⭐ Benefits of Stretta

Non-surgical: Endoscopic procedure only, no cuts or stitches.
Rapid symptom improvement: Reduces heartburn, belching, nausea; results seen in weeks.
Reduces need for medications: Many patients can reduce or stop PPIs.
Strengthens LES: Prevents acid reflux naturally.
Safe for most patients: Suitable for mild to moderate reflux, even if surgery isn’t possible.
Fast recovery: Most return to normal life same day or next day.
Long-term results: Symptom improvement can last years with simple follow-up.
Avoids surgical complications: Reduced risk of infection, bleeding, or post-op hernia.

Candidates for Stretta

Patients with mild to moderate reflux.
Persistent heartburn or nausea despite medications.
Those requiring high doses of PPIs or wanting a non-surgical option.
Patients with small hiatal hernia.
Individuals seeking to reduce or stop acid medication safely.
No major medical contraindications (healthy esophagus, no active ulcers, no conditions preventing endoscopy).
Willing to adopt lifestyle changes: Healthy diet, weight control, avoiding trigger foods.

❌ Contraindications

Severe reflux with large hiatal hernia → usually requires surgery.
Severe esophageal disease: fibrosis, tumors, strictures, active ulcers.
Serious stomach problems: large ulcers, bleeding, complex surgery history.
Bleeding disorders or blood diseases.
Pregnancy or breastfeeding → avoid heat or medications.
Unable to use endoscope due to throat or respiratory issues.
Non-compliance with lifestyle changes.

How Stretta Works

Stretta uses endoscopic radiofrequency energy to strengthen the LES and reduce acid reflux.

Endoscope insertion: Thin scope passed from the mouth to LES with precise electrodes.
Identify heating areas: Doctor selects exact points on the sphincter; pressure measurement may be used.
Apply radiofrequency energy: Heat strengthens sphincter and reduces reflux.
Procedure duration: 30–60 minutes, usually under local anesthesia or mild sedation.
Gradual results: Symptoms improve over weeks—less heartburn, reduced need for medications, better sleep and digestion.
Post-procedure follow-up: Patients usually go home same day or within 24 hours; mild temporary effects may include:
- Slight heartburn
- Mild difficulty swallowing
- Bloating or gas

❌ Side Effects and Risks

Temporary pain or heartburn: Usually resolves in days.
Difficulty swallowing (dysphagia): Temporary.
Bloating or gas: Due to endoscopy and heat; usually resolves.
Esophageal irritation: Temporary, heals quickly.
Minor bleeding: Rare and easily controlled.
Incomplete response: Some patients may not fully improve, especially with severe reflux or large hernia.
Very small risk of esophageal perforation: Rare, mostly managed quickly if detected.
Gradual results: Full symptom relief may take weeks to months.

Before Stretta Procedure

Proper preparation improves outcomes and reduces complications:

Consultation and preliminary tests:
- Visit a gastroenterologist to review symptoms.
- Tests may include:
  - Diagnostic endoscopy to evaluate LES
  - Manometry to measure sphincter strength
  - Occasionally, imaging or ultrasound to check hiatal hernia
- Blood tests and liver/kidney function tests

2. Medication Review

Some medications may need to be adjusted or stopped before the procedure, such as:

Blood thinners (e.g., aspirin or warfarin)
Medications that may irritate the stomach

Tip: Inform your doctor about all medications you are taking.

3. Fasting Before the Procedure

No food or drink for 6–8 hours prior to the procedure.
Purpose: Prevent reflux or vomiting during endoscope insertion.

4. Managing Existing Health Conditions

If you have high blood pressure or diabetes, ensure they are well-controlled before the procedure.
Your doctor may adjust medications or provide specific instructions.

5. Psychological Preparation

The procedure is non-surgical and simple, but relaxation helps reduce anxiety.
Understanding the steps and duration of the procedure provides reassurance.

6. Preparing Your Recovery Environment

Most patients go home the same day or within 24 hours.
Prepare:
- Light drinks
- Easily digestible foods
- Comfortable resting area

7. Final Tips Before the Procedure

Wear comfortable clothing on the day of the procedure.
Have someone accompany you for transport to and from the hospital if needed.
Follow your doctor’s instructions carefully to avoid complications.

❌ Contraindications for Stretta

Stretta is generally safe, but some conditions prevent the procedure to avoid complications or treatment failure:

Severe reflux or large hiatal hernia
- Patients with very large hiatal hernias usually need open surgery or gastric bypass; Stretta is not suitable.
Severe esophageal diseases
- Esophageal fibrosis or severe strictures
- Tumors or esophageal cancer
- Active ulcers or severe inflammation
Serious stomach problems
- Large stomach ulcers or active bleeding
- History of complex gastric surgery
Blood clotting disorders
- Patients with uncontrolled bleeding or clotting disorders are at higher risk.
Pregnancy or breastfeeding
- Procedure not recommended to avoid potential effects on mother or child.
Inability to use an endoscope
- Anatomical abnormalities in the throat or esophagus
- Severe respiratory problems preventing safe endoscope insertion
Non-compliance with healthy lifestyle
- The procedure relies on following a healthy diet and avoiding triggers.
- If the patient is not committed, the procedure may be ineffective.

✅ Signs of Recovery After Stretta

Improvement is gradual, but clear signs indicate success:

Reduced heartburn and acidity
- Symptoms decrease or disappear within a few weeks.
Reduced vomiting or acid regurgitation
- Less reflux, especially at night, improving sleep quality.
Improved swallowing
- LES stronger, difficulty swallowing decreases gradually.
Reduced dependence on acid medications
- Less need for antacids; some patients may stop entirely.
Improvement in extra-digestive symptoms
- Chronic cough, throat irritation, and voice problems from reflux improve.
Decreased bloating or gas
- Gas and bloating related to reflux diminish.
Comfort after meals
- Normal eating without heartburn; feeling full faster thanks to stronger LES.
Medical follow-up improvement
- Endoscopy or esophageal manometry may confirm effectiveness if needed.

Timeline of Stretta Results

1️⃣ First Week:

Some patients notice mild improvement in heartburn or acidity.
Temporary discomfort or bloating is normal and resolves gradually.

2️⃣ Weeks 2–4:

Significant improvement in heartburn and acidity.
Reduced dependence on acid medications.
Less vomiting or regurgitation.

3️⃣ Months 1–2:

Most patients feel comfortable after meals.
Swallowing improves; can eat normal foods without heartburn.
Non-digestive symptoms (cough, throat irritation) improve.

4️⃣ After 3 Months:

Improvements are stable and consistent for most patients.
Most symptoms disappear or significantly reduce.
Many patients stop acid medications completely if they maintain a healthy diet and lifestyle.